Provider Demographics
NPI:1396359899
Name:PIKE, CODY ALAN (NP-C)
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:ALAN
Last Name:PIKE
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-3387
Mailing Address - Country:US
Mailing Address - Phone:423-539-4677
Mailing Address - Fax:
Practice Address - Street 1:18797 ALBERTA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-2127
Practice Address - Country:US
Practice Address - Phone:423-569-8521
Practice Address - Fax:423-286-5309
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28125363LA2100X, 363LF0000X
TN230101163WF0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WF0300XNursing Service ProvidersRegistered NurseFlight